Nocturnal penile tumescence and rigidity monitor

ABSTRACT

A penile rigidity and tumescence monitor apparatus is disclosed. The monitor apparatus includes a transducer apparatus (20) for providing output signals indicative of penile rigidity and tumescence throughout a penile tumescence event. A control apparatus (22) is operatively interconnected to the transducer apparatus (20) for providing control thereover. The control apparatus (22) also provides for acquisition and storage of penile rigidity and tumescence data represented by the output signals received from the transducer apparatus (20).

BACKGROUND OF THE INVENTION

The present invention relates to a nocturnal penile tumescence andrigidity monitor. More particularly, the present invention relates to anocturnal penile tumescence and rigidity monitor which, in addition toproviding for continuous monitoring of tumescence, provides a record ofthe rigidity attained at predetermined intervals during a peniletumescence event. Accordingly, the present invention provides anindication of the duration of rigidity during the penile tumescentevent.

As previously indicated in pending applications, Ser. No. 318,373, filedNov. 5, 1981, and Ser. No. 378,709 filed May 17, 1982, studies haveshown that men with psychogenic impotence generally have normal sleeperections, whereas men with organic impotence have sleep erections thatcorrespond to their impaired wake performance. Such studies have alertedthe scientific community of the potential usefulness of nocturnal peniletumescence monitoring in the differential diagnosis of sexual impotence.As a result of the recognition that nocturnal penile tumescencemonitoring can be of assistance in diagnosing male erectile impotence,various types of devices and techniques for conducting such monitoringhave been developed.

In an article entitled "A Simple and Inexpensive Transducer forQuantitative Measurement of Penile Erection During Sleep", BehaviorResearch Methods and Instrumentation, Volume 1, pages 251-252, 1969,Ismet Karacan describes a mercury strain-gauge transducer for detectingpenile erection. The transducer device is an elastomeric mercury filledtube which is suitably connected to a wheatstone bridge and amplifiercircuit for recording purposes. As the transducer changes size duringpenile erection, its electrical resistance changes thereby causing theamplified output from the wheatstone bridge to change. The amplifiedchanges in the output are recorded enabling penile activity to berecorded.

In an article entitled "Some Characteristics of Nocturnal PenileTumescence in Young Adults", Archives General Psychiatry, Volume 26,pages 351-356, 1972, Ismet Karacan et al. describes the normativecharacteristics of nocturnal penile tumescence (NPT) in a group of 20 to26 year old men who were measured during continuous all-night recordingutilizing the mercury strain-gauge transducer.

Additionally, a number of devices and procedures for monitoring peniletumescence during sleep are noted and referenced in an article entitled"Sleep Related Penile Tumescence as a Function of Age", American Journalof Psychiatry, Volume 132, page 9, September 1975.

In U.S. Pat. No. 4,103,678 issued to Ismet Karacan et al. an apparatusis disclosed for recording minute variations in mercury strain-gaugetransducers positioned at the base and the tip of the penis.

The above-referenced materials relate to nocturnal penile tumescenceactivity and not to the measurement of penile rigidity or hardnessduring the tumescent event. While it is recognized that nocturnal peniletumescence activity is important to the evaluation of organic impotence,another significant aspect in evaluating organic impotence is thequality or rigidity/hardness achieved during the penile tumescent event.

The mercury strain-gauges described by Ismet Karacan provide ameasurement of the changes in penile size during a penile tumescentevent by changing their impedance as they expand and contract withvariations in the penis circumference. The mercury strain-gauges do not,however, provide for measurement of penile rigidity or hardness sincethe strain-gauges are very elastomeric. A very slight amount of forcewill fully expand the strain-gauges just as would a larger amount offorce.

In addition, the mercury strain-gauge necessitates a rather elaboratemonitoring mechanism. The monitoring normally must occur in a healthcare facility under the supervision of trained professionals. Thisrequires that the patient may be in the health care facility overnightand be subjected to fairly elaborate testing. In addition to creating asubstantial imposition on the patient's daily routine, substantialexpense is associated with the support facilities and support personnelrequired to obtain valid test results.

In an article entitled "Nocturnal Penile Tumescence Monitoring withStamps", Urology, Volume 15, pages 171-172, 1980, a stamp technique isdescribed for detecting complete nocturnal erection for the evaluationof impotence. In this technique, a strip of four postage type stamps iswrapped snuggly around the penis, and the overlapping stamp is moistenedto provide a one half to one stamp overlapping seal. The nocturnalpenile tumescent stamps, each one and one quarter by one inch, are madeon ten by eight inch sheets of paper having water base glue on theopposite side. The patients or subjects are able to perform theevaluations at home rather than go to the hospital, resulting insubstantial financial savings. The article indicated that three nightsof inhospital nocturnal penile tumescence testing including directobservation of indicated erections and physicians professional fee,currently cost roughly $500. The stamp testing method costs 30 cents forthree nights of outpatient testing.

The stamps have a tendency to release after being wetted and stucktogether. In addition, the force required to break the perforationsbetween adjacent stamps varies substantially. Thus, the above describedstamp technique does not provide a method for accurately detecting apredetermined penile rigidity or hardness.

In Ser. Nos. 318,373 and 378,709, there is disclosed threshold penilerigidity measuring devices which provide for accurate measurement of apredetermined penile rigidity during a penis tumescence event. However,while these devices provide a safe, simple, accurate and reproducibletest which can be used at home to provide a very effective tool in theevaluation of impotence, they do not provide for measuring and recordingof penile rigidity at various times throughout the tumescence events andaccordingly do not provide any record or indication of the durationwhich the rigidity is maintained. These devices included a ring-likestructure having an attachment mechanism for releasably attaching thering-like structure to a penis. Associated with the ring-like structureis an apparatus for detecting a predetermined force in the peniletumescent event.

The present invention overcomes these and many other problems associatedwith currently available devices.

SUMMARY OF THE INVENTION

The present invention relates to a penile rigidity and tumescencemonitor apparatus comprising transducer means for providing outputsignals indicative of penile rigidity and tumescence. Operativelyassociated with the transducer means is control means for providingcontrol of the transducer means. The control means provides further forthe acquisition of the output signals and storage of penile rigidity andtumescence data represented by said output signals.

In one embodiment of the present invention, the apparatus includes aportable housing having an elongated, non-distensible, flexible memberextending therefrom. The elongated member is constructed and arrangedfor forming a loop-like portion at a first end. The loop-like portion isadapted for releasably encircling a penis about the circumferencethereof. The elongated member is slideably enclosed within a flexible,non-compressible conduit between the loop-like portion and the housing,the non-compressible conduit being suitably attached to the housing. Thepreferred embodiment further includes biasing means positioned withinthe housing and operatively interconnected to a second end of theelongated member within the housing for maintaining the elongated memberin a tensioned condition. The elongated member is further slideablyenclosed in a collapsible, soft sheath along the loop-like portionwhereby changes in the penile circumference result in a displacement ofthe elongated member within the conduit and the sheath. The apparatusfurther includes means operatively interconnected to the elongatedmember for sensing displacement of the elongated member in response tochanges in penile circumference or tumescent activity, the sensing meansproviding an output signal indicative of the displacement andaccordingly the change in penile circumference. Additionally, thepreferred embodiment includes means operatively interconnected to theelongated member for exerting a predetermined force on the elongatedmember by pulling on the elongated member, the force tending to reducethe size of the loop-like portion. The sensing means senses displacementof the elongated member caused by exertion of the above-mentioned forceand provides an output signal indicative of the displacement andaccordingly the penile rigidity, as the penile rigidity will affect theamount of displacement which occurs when the force is exerted on theelongated member. Control means operatively interconnected to thesensing means provides for acquiring the output signals and storingpenile rigidity and tumescence data represented by the output signals,the control means also providing for activation of the force means atpredetermined intervals.

In the preferred embodiment, the biasing means is a constant forcespring attached to the chain or belt of a sprocket drive mechanism. Theelongated member is also suitably attached to the chain or belt of thesprocket drive. The constant force spring maintains a slight tension inthe cable, sufficient to overcome bearing and cable/conduit friction,but not enough to compress a flaccid penis.

In yet another embodiments of the invention, the constant force springmight be replaced by periodically exerting a force on the elongatedmember sufficient to place the elongated member in tension.

In one embodiment of the present invention, the sensing means includesan angular potentiometer operatively interconnected to an idler sprocketof the sprocket drive mechanism. Accordingly, as the elongated member isdisplaced, the potentiometer wiper voltage changes in direct relation tothe displacement of the elongated member.

The predetermined force means in one embodiment of the present inventionincludes a torque motor operatively interconnected to a drive sprocketof the sprocket drive mechanism. By passing a fixed, predeterminedcurrent through the torque motor, a calibrated force is exerted on theloop like portion encircling the penis. The elongated memberdisplacement in response to this calibrated force is a function of thecompressibility or rigidity of the penis.

In still another embodiment of the present invention, the transducermeans monitors penile tumescence only.

In yet other embodiments of the present invention, a second transducermight be mounted within the housing to permit concurrent testing ofpenile base and tip portion rigidities.

The present invention is particularly advantageous in that in thepreferred embodiment it provides for continuous monitoring of peniletumescence and further provides for measurement of penile rigiditythroughout the penile tumescent events. Accordingly, the presentinvention provides a trace or record of the tumescence and rigidity atvarious times throughout the penile tumescent events and provides formeasurement of rigidity duration.

Furthermore, the present invention is ambulatory, enabling its use at aremote site, such as a patient's home, away from the hospital.Accordingly, the testing or screening can be performed with very littleimpact on a person's daily routine or schedule by not requiring that thesubject stay overnight in a health care facility. Additionally, thepresent invention in its simplest form requires little supportequipment, special facilities or support personnel. Thus, the presentinvention provides a simple but effective and accurate technique formonitoring penile rigidity and tumescence during penile tumescent eventswhile a person is sleeping at home. Additionally, since there is no tapeor other complicated attachments to the body, there is no discomfort tothe patient, thereby allowing the patient to attain a restful night'ssleep while the testing is performed.

In a preferred embodiment, the present invention further includes acontrol processor unit programmed with an algorithm so as to be capableof detecting patient tampering thereby greatly increasing the integrityof the data obtained.

In yet other embodiments of the present invention, the penile tumescenceand rigidity monitor includes a data communications link capability soas to permit repetitive nightly testing at home (or at a remote,familiar site) without necessitating personally bringing the collecteddata to the hospital/clinic for interpretation.

These and various other advantages and features of novelty whichcharacterize the invention are pointed out with particularity in theclaims annexed hereto and forming a part hereof. However, for a betterunderstanding of the invention, its advantages, and objects attained byits use, reference should be had to the drawings which form a furtherpart hereof, and to the accompanying descriptive matter, in which thereis illustrated and described a preferred embodiment of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, in which like reference numerals and letters indicatecorresponding parts throughout the several views,

FIG. 1 is a diagrammatic view of a preferred embodiment of a tumescenceand rigidity transducer apparatus in accordance with the principles ofthe present invention;

FIG. 2 is a diagramatic representation of an ambulatory controlapparatus and data logger of a preferred embodiment of the presentinvention interconnected to the transducer apparatus shown in FIG. 1;and,

FIG. 3 is an overall diagramatic view of various data communicationsbetween the transducer/control apparatus and a programmable scannerapparatus and its associated peripherals.

DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT OF THE INVENTION

Referring now to the drawings, there is shown diagramatically in FIG. 1a transducer apparatus of the nocturnal penile rigidity and tumescencemonitor apparatus of the present invention for measuring peniletumescence and rigidity, the transducer apparatus generally referred toby the reference numeral 20. As illustrated in FIG. 2, the transducerapparatus 20 is operatively interconnected to a control apparatus 22providing for control over the transducer apparatus functions and forthe logging or storage of penile tumescence or rigidity data collectedby the transducer apparatus 20. The transducer apparatus 20 and thecontrol apparatus 22 make up the ambulatory nocturnal penile tumescencemonitor of the present invention. Additionally, as further illustratedin FIG. 2, the preferred embodiment of the control apparatus 22 may beoperatively interconnected to a peripheral housing 24 preferablyincluding an adapter/charger 26 enabling the control apparatus 22 to berecharged by plugging the adapter 26 into a conventional 110 voltalternating current outlet. Additionally, in the preferred embodiment,the peripheral housing is shown as including a modem 28 enablingtransfer of data from the nocturnal penile rigidity and tumescencemonitor apparatus to a remotely located system scanner 30 preferablyincluding a programmable central processing unit such as a personalcomputer 32 as generally illustrated in FIG. 3. Additionally, theperipheral housing might also include a tape deck 34 enabling data to berecorded on a cassette and then handcarried to the central systemscanner station. As illustrated in FIG. 3, the penile rigidity andtumescence monitor apparatus might also include a direct connect betweenthe control apparatus 22 and the system scanner 30 as generallyillustrated by the direct connection 36.

More particularly, as illustrated in FIG. 1, the transducer apparatus 20of the preferred embodiment includes a nylon coated, woven,non-distensible cable or elongated member 40 which extends from ahousing 42. The elongated member is slideably enclosed within aflexible, non compressible conduit and a soft, collapsible fabric loopsheath near a first end thereof. The flexible elongated member 40 may belooped back on itself and connected to the conduit 44 by a force limit,snap coupling apparatus 48, thereby enabling the formation of aloop-like structure 38 for positioning around the circumference of apenis 50.

Preferably the force limit, snap coupling 48 is configured such thatupon exertion of a predetermined amount of force, it will release,thereby preventing any injury to the penis. The snap coupling 48 mightbe configured similar to the snap elements disclosed in Ser. No.318,373, filed Nov. 5, 1981.

Mounted inside of the housing 42 is a sprocket chain/belt drive 52,including a drive sprocket 54 and an idler sprocket 56. The elongatedmember 40 is interconnected at an end thereof to a chain or belt 58 ofthe sprocket drive assembly 52.

Additionally, interconnected to the chain or belt 58 is a constant forcespring apparatus 60 which continually maintains a slight tension in theelongated member 40, sufficient to overcome bearing friction of thesprocket drive assembly 52 and cable/conduit friction such that thediameter of the loop-like portion 38 will reflect the circumference ofthe penis 50, but not enough to compress a flaccid penis. Accordingly,any change in penile circumference occurring during a tumescent eventwill result in the elongated member 40 being displaced andcorrespondingly displacement of the chain or belt 58 of the sprocketdrive assembly 52.

An angular potentiometer 62 is attached to the sprocket drive assembly52 by an idler sprocket 64. Preferably, the potentiometer 62 is a 10Kprecision device with a +5 volt reference voltage. Any displacement ofthe elongated member 40 caused by changing penile circumference, resultsin a change in the potentiometer wiper voltage in direct relation to theelongated member's displacement. Accordingly, the potentiometer 62provides a continuous readout of the tumescence activity.

Also operatively interconnected to the drive sprocket 54 of the sprocketdrive assembly 52, is a DC torque motor 66. In the preferred embodimentshown, the torque motor 66 includes a 0 to 5 amp variable direct currentsupply. By passing a fixed, known current through the torque motor whentumescence occurs, a calibration force can be exerted on the loop-likeportion of the elongated member 40 circling the penis. The resultantcable displacement in response to this calibrated force is a function ofthe compressibility or rigidity of the penis. By repetitively cyclingthe motor current at timely intervals, a regular sampling of penilerigidity attained during a penile tumescent event is obtained. Thetorque motor 66 might be activated at more frequent intervals so as toapply a force sufficient to place the cable 40 in tension thereby doingaway with the need for the constant force spring 60.

The outputs of the transducer apparatus 20 are the DC motor currentrepresentative of the motor, torque developed, and the potentiometerwiper voltage representing loop displacement and penile circumferencechange.

It will be appreciated that while in the preferred embodiment a constantforce spring is utilized to continually maintain the elongated member 40in a slightly tension state, alternate methods in keeping within theprincipals of the present invention might be utilized to place theelongated member under tension. Indeed, in some embodiments, thetensioning function might be provided by the torque motor 66 or othermotor apparatus wherein the motor would be periodically activated at asomewhat frequent rate to periodically apply a tensioning force throughthe elogated member 40 and correspondingly placed elongated member 40under tension, thereby doing away with the necessity of the constantforce spring 60. Accordingly, the loop-like portion 38 would beperiodically tightened to reflect the circumference of the penis 50.

Additionally, it will be appreciated that still other methods in keepingwithin the principals of the present invention might be utilized tomonitor displacement of the elongated member 40. In one embodiment ofthe present invention, the angular potentiometer 62 might be suitablyinterconnected to a pully on the drive shaft on the torque motor 66instead of the sprocket chain/belt drive 52. Accordingly, the angularpotentiometer would detect angular displacement of the drive shaft andaccordingly displacement of elongated member 40.

In yet another embodiment, the torque motor 66 and the sprocket drive 52might be replaced by a linear drive apparatus. A shaft encoder mightthen be utilized in conjunction with a linear potentiometer to monitordisplacement of the elongated member 40. Various other embodiments ofthe drive apparatus and sensor apparatus might be utilized in keepingwithin the principals of the present invention.

Furthermore, it will be appreciated that the present invention might beutilized without the penile rigidity monitor function. For example, incertain applications a transducer might be utilized without the DCtorque motor 66 or suitable apparatus for periodically applying thecalibration force. While still capable of monitoring penile tumescence,the transducer would no longer monitor rigidity. In addition, atransducer mounted in a separate housing might be utilized formonitoring the penile rigidity.

A second transducer may also be mounted in the same housing 42 to permitconcurrent testing of penile base and tip portion rigidities asillustrated by 38(b) and 38(a) in FIG. 3.

In use, the end of the elongated member is positioned around thecircumference of the penis and the snap coupling 48 is engaged, so as toform the annular loop-like portion 38 thereabout. The constant forcespring apparatus 60 maintains a slight tension in the elongated member40 sufficient to overcome any resistence in the sprocket drive apparatus52 and cable/conduit friction, but not sufficient to compress a flaccidpenis. As the penile circumference changes, the potentiometer wipervoltage changes in direct relation to displacement of the elongatedmember 40. A fixed, preset current is passed at predetermined intervalsthrough the torque motor 66 when tumescence occurs, thereby exerting acalibrated force on the cable loop 38 encircling the penis. The cabledisplacement in response to this calibrated force is a function of thecompressibility or rigidity of the penis. Repetitive cycling of themotor current at timely intervals provides a regular sampling of penilerigidity attained during a penile tumescence event.

As illustrated in FIG. 2, the control apparatus 22 is operativelyinterconnected to the transducer apparatus 20 to provide a 0 to 5 ampvariable direct current supply to the torque motor 66 and a +5 voltreference voltage for the potentiometer 62. As illustrated in FIG. 2,the control apparatus 22 includes a DC battery 70, a power supply 72, aposition sensor 74, and an electronic control unit including an internalclock 76, a programmable central processing unit 78, a data logger ormemory unit 80, and an interface unit 82. The battery 70 provides thepower for the power supply 72 which in turn provides the direct currentto the torque motor 66 and the +5 volt reference voltage for thepotentiometer. The position sensor 74 senses the potentiometer wipervoltage indicative of loop displacement and penile circumference change.The internal clock 76 is utilized to determine the time and date thatvarious events occur while the central processor unit 78 provides forcontrol over the power supply 72 and the storage of penile rigidity andtumescence data in conjunction with the data logger 80. The interfaceunit 82 enables interface communications with the modem 28 and/or thetape deck 34 and any other peripheral equipment as required.Accordingly, the control apparatus 22 performs all transducer apparatuscontrol, data acquisition and storage, and peripheral interfacecommunications.

The transducer apparatus 20 and the control apparatus 22 are preferablycontained within the same portable mounting frame. Additionally, themounting frame or housing 42 is configured such that the nocturnalpenile tumescence and rigidity monitor is ambulatory in that it performsdata acquisition of all specified physiological inputs while belted orstrapped to the patient. A possible configuration is illustrated in FIG.3, wherein a belt 84 is illustrated as being attached to the housingcontaining both the transducer apparatus 20 and the control apparatus22. In this embodiment, a second transducer is mounted within thehousing 42 to permit concurrent testing of penile base and tip portionrigidities.

The operation of a preferred embodiment of the control apparatus 22 isas follows:

1. Penile Loop(s) are comfortably fitted at the base (and at the tip) ofthe penis, and a base line circumference measurement performed.

2. The circumference of the penis is checked every three seconds withthe last ten data points (adjustable number of data points) stored in ascratchpad memory.

3. If the circumference increases more than 2 mm (adjustable set point),store the ten data points and subsequent data points in the data loggerCMOS RAM (or cassette or bubble or other non-volatile) memory togetherwith the date and time of beginning storage.

4. If the reading is greater than 5 mm (adjustable set point), then turnthe torque motor 66 on for 5 seconds (adjustable period and current),and change the sample interval to one second.

5. If the cable displaces less than 3 mm (adjustable set point),indicating a hard penis, sound the buzzer (optional accessory).

6. As long as the tumescence change exceeds 5 mm (or other presetvalue), repeat step 4 every 3 minutes (adjustable interval).

7. When the reading again falls below 2 mm (or preset value), store timeand date and return system to scratchpad store mode as described in step2.

8. Once an hour, if no tumescence is occurring, a motor cycle asdescribed in step 4 is run, storing also the time and date.

As illustrated in FIG. 3, the nocturnal penile rigidity and tumescencemonitor apparatus is utilized in conjunction with a system scanner 30which is based around a programmable processor such as a personalcomputer. The system scanner 30 enables the setting of adjustableparameters on the control apparatus 22, provides for analysis of penilerigidity and tumescence data, and provides for support and hard copyprint out. It is anticipated that the system scanner 30 will reside atthe clinic or other central site and collect the incoming data fromvarious remote patient sites.

Preferably the personal computer 32 is user friendly with extensive useof menus on a CRT to provide operator instruction and guidance.Preferably, the system scanner with its personal computer 32 and variousperipheral equipment will provide the following functions:

1. Monitor initialization, including preparation for patient use,self-testing, entering of patient name, entering of patient I.D.,updating of the date/time, entering of the monitor apparatus serialnumber, presetting all adjustable values utilized by the algorithmprogrammed into the control apparatus 22.

2. Calibration of the nocturnal penile and tumescence rigidity monitorapparatus, including recording the data together with the time and dateobtained by running one torque motor cycle after fitting a loop to apatient's penis.

3. Down-loading of nocturnal penile tumescence and rigidity monitor datafrom the control apparatus memory (random access memory (RAM)), the tapedeck, and/or the modem which would automatically retrieve session datastored in the control apparatus 22 or the tape unit 34.

4. Data analysis and print-out including analyzing and constructing inusable form for storage and hard copy print-out, penile rigidity andtumescence data of a session or a singular event analysis. Preferably,optional outputs available from this function would include one or allof the following:

(a) 2D graphic (CRT or hard copy) output for time versustumescence/rigidity plots.

(b) 3D graphic (CRT or hard copy) output of time versus tumescenceversus rigidity plots for singular events or entire sessions.

(c) Archive data on tape for later recall without reanalysis.

5. Collection of data from multiple field units by storing data from aparticular field unit when polling the field unit via the modem.Preferably the time report sequence of the field units would bepreprogrammed into the control apparatus 22 during the calibration mode.

In order to provide the above specified functions, the system scanner 30will require additional peripheral equipment in addition to the personalcomputer 32. The personal computer 32 will preferably include adequatememory, for example 64K to 256K, a keyboard 100 and a high resolutiongraphics CRT 102. In the preferred embodiment shown, two disk drives 104are also utilized, however, one may be sufficient for lower useinstallations. A modem 106 positioned either internally of the computeror externally as shown in FIG. 3, will be required at the central siteto provide communications with the modem 28 at the remote site. Asillustrated in FIG. 3, the modems 28 and 106 typically will beinterconnected either directly or acoustically to telephone sets,illustrated by reference numerals 29 and 107. The telephone sets 29 and107 will, in turn, typically be interconnected by a conventional voicegrade telephone-line 118. In addition, if the remote site utilizes thetape deck 34 or data transfer, a corresponding tape deck 108 will berequired at the central site. For hard copy or print out purposes, aprinter and/or plotter 110 will be required. Corresponding RS232Cinterface capabilities will preferably be utilized for the tape deck 108and the printer and/or plotter 110 interfaces. Additionally, a parallelinterface capability might be present for future enhancements of thesystem scanner. The various hardware elements of the system scannermight have disk desk top configuration optimized for minimal areaoccupancy.

In addition to the hardware requirements, the software will includeappropriate operating system software, various utility software such astape, modem, multiplexer mode, plotter, and CRT dump capability, andvarious interface software providing for calibration, downloading anddirect hookup of the nocturnal penile and tumescence rigidity monitor tothe computer 32 to enable real time data transfer for real timefunctional verification of the tumescence and rigidity monitor. Inaddition, software providing for data analysis and number crunching willalso be required. For output purposes, 2D and 3D graphic software may berequired as well as report form generation software enabling patientdata, session data and graphic summaries for hard copy patientreporting. In addition, it is preferred that there be interactive useroperation of software for menu selected CRT graphics, data analysisoptions and printout. As a further support measure, it is preferred thatthe software also provide for patient file bookkeeping, enabling thepatient's files to be updated.

One possible alternate embodiment of the present invention is the use ofa chart recorder in place of or in addition to the system scanner. Thechart recorder will include an analog chart recorder or a dot matrixprinter preferably utilizing standard sized paper. Either a serialRS232C interface (if digital) or an analog specified interface (ifanalog) to the nocturnal penile tumescence rigidity monitor apparatuswill be provided for interconnection of the chart recorder to thepotentiometer output of the monitor apparatus. Accordingly, the chartrecorded will be capable of providing a hard copy of the tumescence datain the real time or at the completion of a session. The chart recorderwill preferably be capable of multichannel operation. While the chartrecorder as currently envisioned will provide only 2D graphicscapability, it will be of minimal size enhancing portability.

Typically, use of the nocturnal penile tumescence and rigidity monitorapparatus will include a scenario having the following phases ofoperation:

1. Patient introduction and monitor initiation.

2. Patient monitoring session.

3. Transfer of session data.

4. Data analysis and reporting.

Prior to patient introduction to the monitor apparatus, the controlapparatus 22 battery is charged and the monitor apparatus isinterconnected to the system scanner 30 for initialization to enter thepatient's name, I.D. number, date/time, modem dial time for automaticreporting, and modem serial number. This information is entered via thekeyboard 100. The initialization information is also stored in thescanner disk patient file for recall and recombination with thecollected session data. From this point on, the monitor apparatus neednot be attached to the system scanner 30. The patient is introduced tothe monitor apparatus by demonstrating monitor calibration andoperation. Monitor calibration is performed by placing the monitor loops38 around a built-in calibration cylinder and pressing a calibrationfunction key 112 on the housing 42 of the monitor apparatus. Uponpressing the calibration function key 112, the monitor apparatus willtake a tumescence and rigidity sample. Force/displacement constants arederived based on the known force applied and the known rigidity of thecalibration cylinder. The constants are then stored internally for theforce displacement transfer function for determining tumescence andrigidity. The monitor loops 38 are then placed around the patient'spenis for finger printing. When the calibrate function key is againpressed, the monitor will take a tumescence and rigidity sample which isstored and identified as a finger print of that patient'scharacteristics. The monitor will continue to sample once a minute untilthe stop function key 114 on the housing 42 is pressed at which time themonitor will shut itself off. (The calibration function key 112initiates the monitoring functions while the stop function key 114terminates the functions.) This exercise serves a two-fold purpose;patient instruction and security for maintaining patient integrity. Themonitor is then detached and given to the patient for home use over apredetermined length of time, e.g. one to five nights of recording.

The patient will calibrate, attach and wear the monitor for consecutivenights until the necessary data is collected. Singular nocturnal sessiondata may be downloaded to tape or to modem daily by simply connectingthe monitor to the peripheral box 24 containing the tape deck 34, modem28 and the AC adapter/charger 26 on awakening. This will transfer thedata collected and recharge the monitor's battery. Session disruption orpatient notations can be made with a patient activated event markerfunction key 116 on the housing 42. Upon pressing the event markerfunction key 116, the date and time is recorded. The patient should thenrecord in a separate log or diary, the reason for the sessiondisruption. This will facilitate interpretation of the data upon beingreturned to the clinic or other central site. Should the battery be weakor dead, the monitor may be connected to the peripheral box via asuitable cord connector. While the unit is no longer ambulatory at thispoint, this is not expected to be the normal operating procedure andshould be avoided when possible.

After having collected the data, the data is transferred to the centralsystem scanner 30. The monitor apparatus provides flexibility of gettingacquired data to the central site (clinic or hospital) in a convenientmanner without impacting the "ambulatory" nature of the device.Following are three data transfer possibilities for the nocturnal peniletumescence and rigidity monitor.

One is the traditional cassette tape transfer which is proven reliablebut somewhat clumsy. The problem is the size of the tape transport; itgreatly increases the ambulatory monitor's size. It also requires morebattery backup (even though it isn't "on" that often in the course ofmonitor session), and that increases battery size and weight. So itsintegration into the ambulatory monitor for data storage is unlikely ifthe monitor is to remain "ambulatory" in the true sense of the word(which implies light weight, small and comfortable). The tape deck 34will be housed in peripheral housing 24 with the battery charger/ACadapter and modem. This configuration requires daily downloading of themonitor data on tape in final archival form. The tape, represented byreference numeral 35, would then be handcarried to the system scanner30. The monitor needs provisions for only one session of data storage.However, if semiconductor storage density is utilized (such as with 2K×8or 8K×8 bit CMOS Static RAM IC's) in the unit itself sufficient for 3monitor sessions, the peripheral box 24 may only be necessary for powersupport, and data would transfer inherently with return of the monitorto the central site and then be down loaded directly into the systemscanner 30.

The second transfer option is the use of the modem 28, ormodulator-demodulator for telephone data communications. The modem,because of size, may also be required to reside in the peripheral box 24with the tape deck 34 and the adapter/charger 26. Its support would beto provide daily update to the clinic of patient data and operationalverification of the monitor. This role may eliminate the need for fieldtape support. The data would be archived on tape or disk at the centralsite. The patient would connect the monitor to the peripheral box 24 atthe conclusion of the monitor session. Preferably, auto modem controlwould take over for the whole reporting process.

The third transfer option downloads the data from the monitor to thesystem scanner 30 via direct connection. This is possible when allsessions are recorded using suitable memory such as solid-state orbubble memory, or when the recording sessions are conducted in closeproximity to the scanner site.

Once data is resident in the system scanner 30, analysis may begin.Penile tumescence and rigidity data, patient data, date/time, etc., isanalyzed and coordinated to present the final hard copy report. Data isanalyzed, formatted and archived on suitable mass storage such ascassette tape for future recall if necessary. The final report mightconsist of a hard copy of any or all of the following information:

(a) patient data--name, ID number;

(b) date/time;

(c) monitor serial number;

(d) "finger print" samples of tumescence and rigidity;

(e) Initialized Thresholds--preset constants in the data analysisequations which may be altered for appropriate reason;

(f) Session Summary--numerical data summary of nocturnal peniletumescence and rigidity events, e.g. max, min, total time, etc., patientactivation notations and verbal description of patient;

(g) 2-D Graphics--superimposition of all or any number of data includingtumescence and rigidity versus time plots for the tip and base loopportions which might be displayed in two forms, entire session data andindividual event data; and,

(h) 3-D Graphics--optional 3-D graphics of entire session or individualevents data which are plots of tumescence vs. rigidity vs. time.

It is to be understood, however, that even though numerouscharacteristics and advantages of the invention have been set forth inthe foregoing description, together with details of the structure andfunction of the invention the disclosure is illustrative only, andchanges may be made in detail, especially in matters of shape, size andarrangement of parts within the principles of the invention, to the fullextent indicated by the broad general meaning of the terms in which theappended claims are expressed.

What is claimed is:
 1. A penile rigidity and tumescence monitorapparatus, comprising:(a) transducer means for providing output signalsindicative of penile rigidity and tumescence throughout a peniletumescence event; and, (b) control means operatively interconnected tosaid transducer means for providing control of said transducer means,said control means further providing for acquisition of said out putsignals.
 2. A monitor apparatus in accordance with claim 1, wherein saidcontrol means includes interface means for providing communication withperipheral equipment.
 3. A monitor apparatus in accordance with claim 1,wherein said control means, in cooperation with said transducer means,further includes means for recording of penile rigidity and tumescencedata throughout the penile tumescent event.
 4. A monitor apparatus inaccordance with claim 3, wherein said control means includes means forrecording the penile data at predetermined intervals.
 5. A monitorapparatus in accordance with claim 3, wherein said monitor apparatusfurther includes means for interfacing with programmable means providingfor analysis of the penile rigidity and tumescence data.
 6. A monitorapparatus in accordance with claim 5, wherein said programmable means incooperation with suitable printer means provides for hard copy printoutof the penile rigidity and tumescence data.
 7. A penile rigidity andtumescence monitor apparatus, comprising:(a) a portable housing; (b) anelongated, non-distensible, flexible member extending from said housing,said elongated member constructed and arranged for forming a loop-likeportion at a first end, said loop-like portion adapted for releasablyencircling a penis about the circumference thereof, said elongatedmember being slideably enclosed within a flexible non-compressibleconduit between said loop-like portion and said housing, saidnon-compressible conduit being fixedly attached to said housing, saidelongated member further being slideably enclosed in a collapsible, softsheath along said loop-like portion; (c) tension means positioned withinsaid housing and operatively interconnected to said elongated member forplacing said elongated member in a tensioned condition, whereby changesin the penile circumference result in a longitudinal displacement ofsaid elongated member with respect to said conduit; (d) sensing meansoperatively interconnected to said elongated member for sensingdisplacement of said elongated member with respect to said conduit inresponse to changes in penile circumference, said sensing meansproviding output signals indicative of said changes in penilecircumference; (e) means operatively interconnected to said elongatedmember for exerting a predetermined force on said elongated member, saidforce means tending to reduce the circumference of the loop-like portionand correspondingly the penis at the location to which it is attached,said sensing means sensing displacement of said elongated member as aresult of said predetermined force applied by said force means andproviding an output signal indicative of changes in the penilecircumference; and, (f) control means for providing control of themonitor apparatus.
 8. A monitor apparatus in accordance with claim 7,wherein said elongated member and said tension means are operativelyinterconnected to a sprocket and chain drive means.
 9. A monitorapparatus in accordance with claim 8, wherein said predetermined forcemeans includes drive motor means operatively interconnected to saidsprocket and chain drive means for driving said sprocket and chain drivemeans.
 10. A monitor apparatus in accordance with claim 9, wherein saidsensing means includes a potentiometer operatively interconnected tosaid sprocket and chain drive means.
 11. A monitor apparatus inaccordance with claim 10, wherein said tension means includes a constantforce spring interconnected to said sprocket and chain drive means. 12.A monitor apparatus in accordance with claim 7, wherein saidpredetermined force means includes means for exerting a predeterminedforce at predetermined intervals.
 13. A monitor apparatus in accordancewith claim 7, wherein said control means includes programmable meansproviding activation of said force means according to a preprogrammedalgorithm.
 14. A monitor apparatus in accordance with claim 13, whereinsaid control means includes means for activating said force means morefrequently during a penile tumescence event than during penileinactivity.
 15. A penile tumescence monitor apparatus, comprising:(a)transducer means providing output signals indicative of peniletumescence, said transducer means including an elongated memberslideably enclosed within a non-compressible sheath along a portionthereof, said elongated member being adapted for forming a loop portionfor releasable attachment about the circumference of a penis, saidelongated member being slideably displaced within said sheath due tochanges in penile circumference, said transducer means including meansfor placing said elongated member in a tensioned condition, saidtransducer means also including means operatively interconnected to saidelongated member for monitoring the displacement of said elongatedmember due to changes in penile circumference; and, (b) control meansoperatively interconnected to said transducer means for providingcontrol of said transducer means.
 16. A monitor apparatus in accordancewith claim 15, said monitor apparatus includes means for exerting apredetermined force on said elongated member tending to reduce the sizeof said loop-like portion and cause slideable displacement of saidelongated member in said sheath, whereby penile rigidity can bedetermined from the change in circumference due to application of saidpredetermined force.
 17. A monitor apparatus in accordance with claim16, wherein said control means includes a programmed processer meanswhich provides for activation of said force means at predeterminedintervals.
 18. A monitor apparatus in accordance with claim 17, whereinsaid programmed processer means includes means for sampling thetransducer signal at different rates depending on the degree oftumescence.
 19. A method of monitoring penile tumescence and rigidity,comprising the steps of:(a) placing an expandable loop around thecircumference of a penis in such a way that penile tumescence isreflected in changes in the circumference of the loop; (b) measuring thecircumference of the loop at predetermined intervals; (c) storing thecircumference measurement if the current measurement is different thanthe measurement at the previous interval by a first predeterminedamount, whereby a record of tumescence is stored; (d) reducing thecircumference of the loop under a predetermined force if the currentmeasurement is different than the measurement at the previous intervalby a second predetermined amount; and, (e) measuring the change incircumference of said loop due to the application of said predeterminedforce, and utilizing said change as an indication of rigidity.